JEP Question - Doctors’ fees

The JEP has invited the 21 Senatorial candidates to answer a series of questions covering a wide range of key topics in the election.

Question: Should the States pay more towards the cost of visits to the doctor?


Mark Forskitt
I do not have enough information on the costs and benefits of doing this to give a definitive answer, but it seems a desirable proposition, especially for the chronically ill who have to make serial visits to the doctor.

Mike Higgins
This is an area that must be investigated. Doctors are among the most respected people in our community. They are well paid and we need to see if we are getting value for money. The cost of going to the doctor is crippling to some members of our society, so much so that they do not go and get the treatment they need and deserve. I believe in everyone receiving the health care they need, not based on what they can afford. If a review shows that we are getting value for money from doctors’ services I would support additional payments.

Mick Pashley
I don’t feel that there is any immediate need to increase funding for doctors’ visits at present, although this is related directly to how much I pay at mine and how often I go! The hospital will always offer free consultations for emergency visits and many businesses offer free medical cover as part of a benefit package, and at present I feel that this does work well.

Senator Mike Vibert
The States paying more towards the cost of visits to the doctor would not achieve anything if it simply resulted in doctors’ charges rising. A better relationship between general practitioners and our Health Service needs to be developed. This is being addressed in New Directions, which is looking at how doctors and the General Hospital can best be integrated in terms of health care for the public. What is vital is that no-one is deterred from visiting the doctor because of the cost involved and such issues should be covered for the less well-off by the income support system.

Montfort Tadier
Doctors’ fees are prohibitively high for many people. There is currently an issue with those who are on limited means seeking treatment at A&E for this very reason, even though their sicknesses are not necessarily emergencies. I favour free doctor visits for all. This could be funded, if necessary, by lifting the social security cap on contributions for high earners.

Nick Palmer
Competition doesn’t seem to work to bring down doctors’ fees does it? This is asking the States to subsidise private enterprise more, so should be looked at very carefully. There are some people who have recurring problems and they can be crippled by doctors’ fees, even on ordinary incomes, so clearly there should be some mechanism to help them. The devil is in the detail.

Senator Paul Routier
The subsidy towards visiting the doctor and receiving treatment was recently increased with the provision of free prescriptions. This has been welcomed, especially by those with chronic conditions who require several prescriptions. The Health Insurance Fund which subsidises the cost of GP visits and prescriptions is paid for by contributions from employees and employers. I will support the greater co-ordination of the health services provided by consultants, GPs and pharmacies and then the use of the Health Insurance Fund to enable better access to any medical care that is needed.

Deputy Peter Troy
For those on low incomes the income support rates have included within them the cost of four visits to the doctor per person per annum. A household medical account can be opened and the funds put aside to be utilised on doctors visits. Someone with a higher medical dependency can apply for more doctors’ visits, the cost of which will be covered for them by Social Security.

Senator Philip Ozouf
Yes. The whole system of primary care needs reform. The Health Insurance Scheme is currently running with an annual surplus of £10 million with more than £60 million in the bank. Some of this fund should be used to subsidise visits to the doctor and also extend non-means-tested preventative care and screening, especially for senior citizens.

Deputy Sarah Ferguson
Why are the costs of going to the doctor so high? Perhaps the JCRA should investigate. Certainly those who were on HIE should be helped – but this is one of the areas where I think the forms required to apply for the various components of income support have been somewhat confusing, helped by the fact that it is a new system and the staff are not yet totally familiar with it.

Trevor Pitman
Yes. Affordable health care is surely one of the cornerstones of any true and modern democracy. Indeed, it is an area of government that even many developing countries with far less resources at their disposal than us manage to target as a matter of principle. The question must be: why? In Jersey we have a robust economy producing tax revenue and Health Fund surpluses. Despite this the minister responsible has now removed free access to GPs for what I believe is around 4,000 people under income support. Removing this from disadvantaged people who genuinely need such access is wrong.

Adrian Walsh
Yes.

Deputy Alan Breckon
Paying doctors’ costs for home or surgery visits is a concern to many people, especially those just above income support thresholds with children, or the elderly. Targeted support would be better than assistance for all. Prescription charges should not have been abolished. Assistance could have been focused on assisting others with medical, optical and dental treatment.

Deputy Alan Maclean
Those who can’t afford to visit the doctor should have the necessary support to ensure that they can. Otherwise the hospital’s A&E department faces an increased burden of non-emergencies, which is a false economy. In some cases, people will put off visits to their doctor, leading to more serious illness and ultimately greater cost to the health care system. A full cost-benefit analysis needs to be undertaken and balanced with social responsibility.

Chris Perkins
Visiting the family doctor is becoming prohibitively expensive and essential visits are probably being put off because of the expense. The recent move to make prescriptions free for all has not targeted those who need help the most. Rich and poor have benefited to the same extent and Social Security could be faced with a much increased drugs bill, as patients receive drugs on prescription that they may at one time have paid for themselves. There should once again be a charge for prescriptions and the funds from this put toward reducing the cost of visiting the doctor.

Cliff Le Clercq
The last thing a sick person needs is additional stress and worry or cutting back on doctor visits because of financial fear, so of course the States should pay more.

Deputy Geoff Southern
We have a healthy economy producing tax revenue and Health Fund surpluses, but the minister has removed free access to GPs for some 4,000 people under income support. Such a backward step is unheard of in the western world. I have proposed that free GP access should be extended to the 9,000 worst-off in our community to target the chronically sick and disabled, pensioners and children. This was opposed by the Social Security Minister. I will return with a fully costed scheme to restore free GP services in 2009 with a view to expanding it to all residents in five years.

Ian Le Marquand
Currently, drug prescriptions are free and £15 towards the cost of GP visits comes from Social Security. Income support is also meant to cover the cost of a reasonable number of visits to the doctor. This is an area in which the States should aim to gradually increase the £15, as the financial position allows. There is also
an issue as to how well the new income support system is working. There appear to be cases in which people are having difficulty in obtaining the same level of medical support which they need and used to have.

Jeremy Maçon
We should reintroduce HIE. This was an excellent system and currently low-income support only pays for four visits to the doctor. This is ridiculous for those on a low income who have to go to the doctor regularly for check-ups or tests. We were better off under the old system, where those who could not afford care did not have to worry about going to the doctor or calling him out if they had to. Now, if they fall sick they have the added stress of how to pay for it and what they will have to do without.

Daniel Wimberley
The principle is clear: no-one should be barred from going to the doctor because they cannot afford it. I believe in equal opportunities so that everyone can enjoy their life to the fullest possible extent. The emphasis has to be on health promotion – better and cheaper than cure – but when illness, disability or accident strike, then we all owe it to each other to help out. That is how our society works and it took a lot of struggle to get to this point. The details of the funding – insurance, taxation, means testing etc – are means to an end.

Nick Le Cornu
The change in HIE rules has caused hardship and confusion for many people and free doctor visits are essential for many with limited income. Our supposedly caring society needs to address the issues of providing chiropody and dental treatment, too, on a much more
holistic basis for all our residents.